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Report Confirms Source of Contaminated Heparin
Date:12/3/2008

used in supplements to treat arthritic joints. Oversulfation results from processing of the substance. Most of the reactions reported in the United States occurred in dialysis centers among people given high initial doses of heparin, the report found.

The heparin incident illustrates the importance of health providers reporting untoward incidents to regulatory authorities, Patel said. "Public health always relies on providers to make these reports," she said. "If they don't report, we have no way of finding what is wrong and correcting it. We are always asking people to be on their toes and communicate any problems."

Meanwhile, a letter in the same issue of the journal described a much easier way of identifying oversulfated chondroitin sulfate (OSCS) contamination in heparin -- should it occur again.

The two tests now mandated to detect contamination -- capillary electrophoresis and nuclear magnetic resonance spectroscopy -- are "technically challenging, not widely established and not easily applicable in clinical practice," said the letter from researchers at Christian-Albrechts University in Kiel, Germany.

That letter reported successful identification of OSCS contamination in heparin by use of one of the most common tests in medical practice --measuring prothrombin time, the time required for blood to clot, or coagulate. Studies show that coagulation time goes down as the amount of OSCS in a blood sample goes up, the letter said.

The test is widely available because many people, such as those taking the blood-thinning drug Coumadin for conditions such as atrial fibrillation, must have their clotting time assessed periodically.

"This test is applicable for any clinical laboratory, in the United States and Europe," said Susannne Alban, a professor of pharmacy and co-author of the letter. "It could be used as a pre-test, to detect the problem before any symptoms are seen."

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